Extracorporeal treatment for ethylene glycol poisoning: systematic review and recommendations from the EXTRIP workgroup
Methodological detailsEXTRIP workgroup, GRADE approach
- EXTRIP workgroup
- GRADE approach
Recommendations
As issued by the authors
- Suggest (weak/conditional); very low quality of evidence
ECTR if fomepizole is used and ethylene glycol (EG) concentration > 50 mmol/L OR osmol gap > 50
- Recommend (strong); very low quality of evidence
ECTR if ethanol is used and EG concentration > 50 mmol/L OR osmol gap > 50
- Recommend (strong); very low quality of evidence
ECTR if glycolate concentration is > 12 mmol/L or anion gap > 27 mmol/L
- Suggest (weak/conditional); very low quality of evidence
ECTR if glycolate concentration 8-12 mmol/L or anion gap 23-27 mmol/L
- Recommend (strong); very low quality of evidence
ECTR if there are severe clinical features (coma, seizures, or acute kidney injury (AKI))
- Recommend
In most settings, intermittent hemodialysis over other extracorporeal treatments (ECTRs)
- Recommend
If intermittent hemodialysis is not available, CKRT over other types of ECTR
- Recommend
Cessation of ECTR once the anion gap is < 18 mmol/L
- Suggest
Cessation of ECTR if EG concentration is < 4 mmol/L
The dosage of antidotes (fomepizole or ethanol) needs to be adjusted during ECTR
Original publication
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